Organization
WEST COUNTY HEALTH CENTERS, INC.
Active
Other names
Russian River Health Center Bldg #2 Annex
Organization subpart
No
Provider details
NPI number
Authorized official
VIKKI MINNIFIELD (BILLING MANAGER)
(707) 869-5977
Entity
Organization
Contact information
Practice address
16312 THIRD ST, GUERNEVILLE, CA 95446
(707) 869-5977
(707) 869-5976
Mailing address
PO BOX 1449, GUERNEVILLE, CA 95446-1449
(707) 869-5977
(707) 869-5976
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
110000492
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1598786352
—
CA
Enumeration date
10/19/2016
Last updated
10/19/2016
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